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Inspection on 28/10/08 for Castle House
Also see our care home review for Castle House for more information
This inspection was carried out on 28th October 2008.
CSCI found this care home to be providing an Good service.
The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.
Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Castle House 76-78 St Botophs`s Rd Barton Seagrave Kettering Northants NN15 6SS The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Fiona Stephenson Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area
Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home
Name of care home: Address: Castle House 76-78 St Botophs`s Rd Barton Seagrave Kettering Northants NN15 6SS 01536522565 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Vista Care Ltd Name of registered manager (if applicable) Mrs Susan Rodriguez John Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 10 0 care home 10 learning disability Additional conditions: The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is 10 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Castle House is a care home registered to provide care for up to 10 people with learning disabilities. It is owned by Vista Care Ltd. The house is situated in the village of Barton Seagrave, near Kettering. The village has a local post office and church, and the bus stop near the home takes people into the neighbouring towns. Castle House is a two storey home. The ground floor has a kitchen, conservatory, utility room, cloakroom, shower room, and large lounge/dining area. The first floor has six single bedrooms and one shared bedroom. Three of the single rooms have ensuite facilities, and there is a shared bathroom. Attached to the home, is a flat shared by two service users. There is parking to the front of the home, and a good sized garden to the rear. During our inspection visit we were told the fees range from £518 - £713 per week. Care Homes for Adults (18-65 years) Page 5 of 30 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home We did this key (main) inspection by visiting Castle House on the 28th October 2008. The visit started at 12.30pm and lasted a total of 5.5 hours. As part of the inspection, we also looked at the Annual Quality Assurance Assessment (AQAA) sent by the service to the CSCI. This is information sent by the owner of the service each year to tells us what they think of the service they provide. We also looked at other information sent to us. As part of the inspection we sent out Have your say about Castle House surveys to staff, people who live at Castle House, and their families. Six surveys were sent back to us. To find out about the service given at Castle House, we talked to five people who live at the home, and asked staff about how they helped peoples needs were met. We also looked at the care plans, medical records and daily notes for four people. This is called case tracking. What we have written below is based on what we saw and what we were told on the day of inspection. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well We saw that staff were friendly with people who live in the home and treated them well. We saw that people at the home are helped to see family and friends, and to make new friendships if they want to. We found that staff speak to people from other organisations to help them in making sure they give good care. These can be nurses, doctors and other people who help with health matters. One health care professional said Care staff have developed good working relationships with Community Nurses, and Partnership working is effective. Care Homes for Adults (18-65 years) Page 8 of 30 We saw people living at the home and the staff who help them, enjoying good conversations. All people we spoke with or saw, showed they were happy living at Castle House. Three people who live at Castle House sent back the Have your Say survey. One said Its a great home. Im happy at Castle House and the food is good. Another said Where I live is a nice place and I am happy here. I have nice friends in my home. The staff are nice. The third person said I like living here, I like dinners and I like my room. One family member who completed the Have your say survey said very nice things about the service, saying their relative had always been given a very high level of care. The home is well decorated, and clean and tidy. Furnishings are homely, and add to the family home feeling. Care Homes for Adults (18-65 years) Page 9 of 30 What has got better from the last inspection What the care home could do better The service could help people living at the home understand information which is there to help them, by writing it in a more easy to understand way. Medication management is good, but medicines that need to be put in a fridge to keep them cold were being put in tin, then into a fridge which holds food. These medicines must be put in a different fridge. No one living at the home is currently taking very strong medicine called controlled medication. If a person were to take this medicine it would have to be stored in a controlled medication
Care Homes for Adults (18-65 years) Page 10 of 30 cupboard. The service does not have one of these, and it needs to have one just in case someone does need to take controlled medicine. Having a controlled cupboard in the home makes sure that the service will store the medicine in a legal way. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Fiona Stephenson
Nottingham (Edgeley Ho) LO Tottle Road Riverside Business Park Nottingham NG2 1RT If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning
Care Homes for Adults (18-65 years) Page 11 of 30 our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 12 of 30 Details of our findings
Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 of 30 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who may use the service and their representatives have the information needed to choose a home that will meet their needs, although not all the information is in a format easily accessible for people with learning difficulties. Evidence: We checked the care records of four people who live at Castle House. The needs of people living at the home were fully assessed by Northants County Council prior to admission to the home. The assessments were then used well by staff working at Castle House to work with people who live at the home in setting up care plans and risk assessments. The home provides a Statement of Purpose and Service User guide. The Statement of Purpose is a legal document which sets out the aims and objectives of the home, and the facilities and services which are to be provided by the registered person for people who live at the home. The Statement of Purpose and Service User guide are not set out in a style that is easy for people living at Castle House to understand e.g. easy read/picture format or large print. Management have identified this as an area for improvement in their AQAA (Annual Quality Assurance Assessment). This is a document all services have to send to the CSCI each year to inform us of how they are
Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: meeting outcomes for people who use the service. The statement of purpose had not been updated to reflect the change in ownership of the home, and some of the information shown was inaccurate. Care Homes for Adults (18-65 years) Page 15 of 30 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People living at Castle House are actively involved in decisions made about their lives, and are provided with good support to live the life they wish. Evidence: We (the CSCI) saw good care plans, which looked at all areas of the individuals life. The care plans were detailed, and included comprehensive risk assessments which were reviewed when necessary. The management of risk is positive in addressing safety issues while aiming to ensure that people living at the home have active and fulfilling lives. We saw that the service involves people who live at the home in planning their care. Staff understand the importance of people who live at Castle House being supported in taking control of their lives. The care plans, although providing excellent information, are not yet written in a person centred way, or in a format easy for service users to understand. Management are addressing this, and showed us a draft person centred plan. This plan was written with the resident, and from their perspective. We were informed that the intention is all care plans will become person centred by the end of November 2008.
Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: People who live at Castle House are consulted regularly to gather information about their satisfaction with the home. Resident Meetings are held and the views of residents are recorded in the minutes of the meeting. The minutes are read out to people who live at the home, but are not recorded in a way that is accessible to people who live there. Also, they do not always identify the action that will be taken to resolve a question raised by a person living at the home. Care Homes for Adults (18-65 years) Page 17 of 30 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live at Castle House are able to make choices about their lifestyles and are supported in developing life skills. Evidence: Through looking at care records, and speaking with staff and people who live at Castle House, we found that people who live at the home have good opportunities for personal development, and to take part in leisure and social activities. People who live at Castle House are part of the local community and use the facilities in the village as well as in the surrounding towns. Management and staff support people who live at the home to choose from a range of activities by bringing information to the home and by communicating what is on offer to people who live there. They help to plan and support people with going on local trips and activities as well as holidays. People living at the home maintain good family relationships, and have developed good friendships with each other. Personal relationships are well supported, with good information and specialist guidance sought by staff to help people make appropriate
Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: decisions. The menu at Castle House shows a wide range of meals, and people living at the home said they liked the food provided. After consultation with people living in the home, the menu is in the process of being changed to provide meals that are not currently available. Care records and menu records clearly show the likes and dislikes of people at the home, to ensure that no-one receives food they dislike. Care Homes for Adults (18-65 years) Page 19 of 30 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live at Castle House have their physical and emotional health needs met well. Evidence: We saw care planning that is responsive to the personal and health care needs of people living at Castle House. Records give a comprehensive overview of each persons needs. Personal care is delivered in a way which respects the privacy and dignity of people living at Castle House. People are supported and helped to be independent and can take responsibility for their personal care needs. Staff have listened, and take account of what is important to them. Medication is managed well. Staff have undertaken appropriate training in the safe handling of medicines, and the service has good systems in place to ensure that medicines are administered safely. Medication that requires refrigeration is currently housed in a tin in the fridge used for storing food. This is not good practice and needs to be housed in a fridge used for medication only. The service does not administer controlled drugs to service users living at Castle House and as such does not have a controlled drugs cabinet. One must be put in place in the event that a service user is prescribed a controlled
Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: drug to ensure the service is compliant with the legislation. Care Homes for Adults (18-65 years) Page 21 of 30 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People living at Castle House can be confident that their opinions will be respected and acted upon, and that they are protected from abuse, neglect and self harm. Evidence: We observed an open culture that allows people who live at Castle House to express their views and concerns in a safe and understanding environment. People who live at the home and their relatives say they are happy with the service provided. There is a complaints procedure which is supplied to people living at the home, and is displayed on the notice board in the home. As with other information at Castle House it is not written in an easy read format to make it more accessible for people with learning disabilities. All staff working in the home are fully trained to understand what to do if they are concerned about the welfare of people living at the home, or if they have concerns that abusive practice is happening. A referral has been made to Social Services under the Safeguarding Adults procedures, but this was not upheld. Management were supportive and helpful whilst the investigation was being carried out. Care Homes for Adults (18-65 years) Page 22 of 30 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The living environment is homely, clean, safe and comfortable, well maintained and reflects the needs of the people who live there. Evidence: Care records, and observation during the visit to Castle House showed that people living at Castle House are encouraged to see the home as their own. The home has the feel of a family home. The location of the home means there is good access to community facilities and services which people living there use well. The bedrooms we saw, were individualised and reflected the personalities of the people whose rooms they were. Most bedrooms have en-suite facilities. Communal bathrooms were seen to be decorated to a good standard and to give a homely feel. All areas of the home were observed to be very clean and tidy, with furnishings that added to the homely feel of the place. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People living at Castle House are supported by an effective and well trained staff team. Evidence: We found through relative and service user surveys that people who live at Castle House, and their relatives, have confidence in the people who care for them. Staff rotas showed there are enough people on duty to make sure that peoples needs are being met. We observed there were enough staff on duty to enable staff to spend time talking to people as well as undertaking care tasks. We observed staff and people living at Castle House living and working together in a relaxed and happy atmosphere. Staff members undertake external qualifications beyond the basic requirements. Staff training and supervision is seen as important, and staff have received training in all aspects of care to ensure they carry out their work safely. Recruitment procedures meet the statutory requirements. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The conduct and management of Castle House fosters an atmosphere of openness and respect,where people who live at the home, their relatives, and staff feel valued and that their opinions matter. Evidence: The registered manager and deputy manager work well as a team to support staff and ensure that people living at Castle House benefit from a well run home. People living at the home and their relatives, said they feel able to talk to staff or management about any problems they have, and there are also more formal systems in place to communicate views about the home such as the Residents Meeting. An action plan has been devised to improve aspects of the service, in particular to ensure that care plans are written from a person-centred perspective, and to ensure written information is in a format which can be understood more easily by people living at the home. This focused on the statement of purpose, service user guide, and menus, but did not include other written information such as the notes of Resident Meetings, and Questionnaires given to service users as part of the user satisfaction audits.
Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: All health and safety requirements have been implemented and reviewed to ensure that people who live at Castle House live in a safe environment. The AQAA (Annual Quality Assurance Assessment) sent to the CSCI by the manager gave clear information about what the service does well, and what improvements are needed. It reflected what we saw when we visited the service. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes ï£ No ï Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set
No Standard Regulation Description Timescale for action 1 1 4 The service must ensure the Statement of Purpose provides information about the new provider, and that all other information is an accurate reflection of the services being provided. 29/12/2008 This is a legal document which provides service users and their representatives the information they need to help them make informed decisions about the service. 2 18 13 The service must ensure that 28/11/2008 medication requiring refrigeration is housed in a separate fridge. To meet the good practice guidelines as set out by the Royal Pharmaceutical Society of Great Britain.
Care Homes for Adults (18-65 years) Page 28 of 30 3 18 13 The service must ensure there is a controlled drug cupboard that meets the requirement of the Misuse of Drugs (safe custody) regulations 1973. 28/04/2009 To ensure the home is compliant with the legislation should a person living at the home require the administration of a controlled drug. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 4 Ensure the Statement of Purpose, Service User Guide, and all other written communication is undertaken in a format more easily understood by people who live at Castle House. Continue to develop Service User Plans so that all people living at Castle House have a Person Centred Plan. 2 6 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website.
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